How Much to Charge as a Forensic PsychologistApr 02, 2023
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What are antitrust laws and how are they relevant to this post about psychology rates?
A different kind of disclaimer has to go before anything else today, and that’s because the moment the topic of rates comes up, people want to start shouting about rate fixing, antitrust laws, and (in clinical spaces for these conversations, proprietary insurance contracts). It’s very predictable that when someone raises a public question about rates, people will scurry to the privacy of DMs and whispered conversations. So, to be very clear from the start, I am not suggesting you do or do not set your rate at any particular place. Virtually all of the information in this post is public information and clearly stated in various place on my website.
In this post, I will be stating my rates, and some rate ranges I have observed with my own senses from others over the years. Publicly stating what you charge is not an act of antitrust. It is an act of courtesy to your consumer, an act of transparency for your business, and integral to an attorney trying to determine if your services are in their budget for proceedings. It’s interesting to me that we have convinced many psychologists otherwise, and scolded each other into silence.
What is an antitrust law?
Well, it’s actually 3 specific Acts and a broad group of off-shooting state and federal laws that regulate trade and commerce to make sure business are competing fairly. The Sherman Act is the backbone for many of these laws and rules, and essentially what it does is restrain price fixing, market allocation, boycotts, bid rigging and tying agreements.
Clearly, I am in no way suggesting that you do any of those things. In fact, I’m not a lawyer, but I think I’m on safe ground to specifically advise you not to do any of those things. The “anti” part of antitrust is “anti” businesses grouping up to dictate market pricing. So, do not group up with your colleagues and conspire to dictate market pricing. I am otherwise offering no agreement, nor encouragement of anything besides you figuring out your own individual rate. Actually, maybe I'm also encouraging our group to be more transparent, collectively, about our pricing.
Market research is a normal part of absolutely any honest and responsible business venture – one obviously needs to look around and see what others are charging as one data point in setting rates (the others being your expenses, your personal financial needs and goals, etc.). And in other industries, it’s a lot easier and more obvious to see the costs of “competitors.” Target watches Best Buy who watches Amazon who watches Apple so that everyone puts their Airpods on sale at the same time. Old Navy can see at any time what H&M is charging for pants. Safeway can walk into any store anywhere to see what Whole Foods is charging for an apple. So it’s not fair, and it’s not in the spirit of antitrust laws, to say that just because our rates haven’t historically been as public, that we are compelled to keep them secret.
So, rates matter. The market matters. Rates are not a secret. And in response to this one data point I am avidly suggesting that you do what is best for you, individually. Beyond that, it is not an antitrust violation to say what you charge, and to offer generally what you have seen others charge, so that clinicians can use this market research to help them make these very personal decisions as they launch their business. Once you launch, price adjusting becomes much more about supply and demand, and your own experimentation with the impact of your rates on your referral streams.
But what about insurance rules?
Well, insurance rules are irrelevant to us because we’re in forensics, so there are some things that can’t be generalized there. But for those of you in clinical or neuropsychological practice, you do have to be more careful if you take insurance. I'm aware that historically, there have been clauses in insurance contracts prohibiting you from sharing your rate. That said, more recent legislation has required insurance providers to be more forthright about their rates and post them publicly. As of this writing, I believe that means they’ve mostly just dumped them into endless streams of data online, but eventually some nice folks will come along and turn it into provider friendly information so you know how insurance is reimbursing in your area.
Why are we still talking about antitrust? What about the fact that we don’t like talking about money?
Ok, so now that we got the anti-trust disclaimer out of the way, let’s talk about the other elephant in the room, which is that money makes people uncomfortable. But that's our own stuff to unpack, and I think it does a disservice to our consumers and to our field when we’re cagey with our rates. If someone goes to your website and they have to contact you to find out what you charge, that's frustrating to me. The same way I won’t make a reservation at a restaurant that posts their menu online without the item costs. It feels pretentious, deceptive, and like someone is trying to take advantage of you as a consumer. You’re a captive audience once they have you at a table, and we should all be able to make an informed decision before sitting down. So I believe very strongly that we owe it to the consumer to make our rates clear, transparent, and public.
Why else is this important?
Well, we also owe it to each other. From a social justice lens, women and people of color make less than White male counterparts, in virtually every arena everywhere. It is very important that my more qualified, more seasoned, more talented colleague can consider my rates as she sets her own. Is that price fixing? No. It’s capitalism. Say what you want about capitalism, but that’s the ballpark we’re playing in. She’s better, she gets to charge more. At minimum, she should be able to know she’s equal, or if she’s making 68 cents to my dollar or whatever the current number is that is always so painfully, unacceptably unfair.
So, are you ever going to talk about your rates?
I charge $220/hr for forensic work. I charge the same for all kinds of work, and I post a sample invoice and retainer agreement on my website, too.
What about other people’s rates?
This varies wildly by location. I was originally licensed in California and made more as a post-doc in a forensic private practice than I do now here in the Midwest. And a factor here is that many forensic rates are dictated by states or contracts from large referral sources, so sometimes our rate doesn't matter. But if you're able to wander around to any other websites in your area, hopefully there are folks there with a similar value system around transparency to help you get a sense about the range you want to aim for. And worst case scenario, the market will correct you. If you absolutely can't get information and you go too high, someone may tell you directly or else people will vote with their feet. And if you go too low, you may find yourself buried in referrals (although, paradoxically, sometimes this can have the opposite effect in that people will assume something is wrong with you if you're too low).
What about flat fees?
Yes, flat fees are acceptable. You have to be careful that quality doesn’t suffer though. It’s very tempting to cut corners if you make the same amount in 5 hours versus 8. Also, it’s ripe for resentment if the case ends up taking 15. For these reasons, I charge hourly, and give consumers a clear estimate about the average timeframe for the types of services I offer.
But if I were to switch to a flat fee, I’d take the amount of hours in the middle of my estimated range and multiply it by my hourly rate to get that flat fee cost. (If I did this right at this moment it would mean a flat fee of $2860 per competency evaluation. This is two to four times the actual paid rate for most of those because case law requires states to pay for them, and just like insurance, when they control the market they get to set rates well below the market costs. Which means, they’re having trouble finding and keeping seasoned examiners to do those evaluations, and I think this is contributing to the examiner shortages across the country. I'm not sure where that all is headed, but that's another topic for another time.
Unfortunately, just like insurance and clinical work, what tends to happen is that people will do the state capped work starting out, build enough experience to switch to the kinds of work that will pay higher rates, and leave the lower paying jobs for less seasoned clinicians. I personally see my state evaluations as a part of giving back, but that means it goes into the same category as pro bono/sliding scale work. Because of that, I can only hold out so many cases and I need my “regular” work to actually cover expenses. I wish I had an answer for this, but I just don’t. States are going to have to keep picking up their rates to get decent examinations, lower their standards, or keep scrambling.
What does this mean for consumers?
Well, consumers also have to make their own individual decisions about these things. But I think it probably means that they might want to ask some questions about what they’re getting if they're being quoted services below $100 or above $400 an hour, because those might be more unusual under the curve. Of course, it may be that those charging below that are highly committed to accessible services, and those charging more are just that in-demand. Consumers get to do market research and make their own decisions about what’s best for them, too.
What if I do primarily clinical work? Can I charge a separate forensic rate?
Yes, you can do that, as long as it’s in your intake paperwork and disclosures. It is fairly standard to charge more for forensic work than clinical.
As a broad average here, many clinical private practice rates in CA start at a floor of $200/hr, and many start higher. Whereas in Minnesota, that clinical floor starts at more like $150 and goes up from there. So region matters, but so does specialty. Because you might see those same floor rates in CA starting at $250 for forensic work, and at $175 in Minnesota, and going way up from there. On top of this, not only does region and category of work matter, but so does the specialization within it. Family Court/custody work will almost always charge higher rates than other types of forensic work because it is so litigious and comes with so much risk (which means increased costs for training, insurance, consultation, etc., but also the kinds of rates needed to make people willing to deal with that kind of stress are just plain higher).
Wherever you end up in your clinical and forensic rates based on your region, I hope you will consider keeping the proportion reasonable for your forensic rate. That higher rate reflects the increased risk as well as the training/specialization required to do forensic work. But it bothers me when clinicians charge double their clinical rate, especially when that charge puts them well above the typical going rates in their area for forensic work.
I will go so far as to say that I think it is unethical to price your services defensively, in hopes of not being called into Court.
Lastly, I do think it is ok to charge your hourly rate for a reasonable amount of research and consultation if you are a clinical specialist and you’re being called in as a fact witness, enough to get you to a minimum level of understanding for practice since this is not a typical part of your services or training. But you should check with your malpractice carrier to be sure that’s above board. If you’re a clinical specialist and you’re trying to figure out how to respond to a subpoena or want to know more about the differences between clinical and forensic cases, check this out.
Can I charge differently for different forensic tasks?
Yes, but I don’t recommend it. All the tasks are part of the job. They’re all important, and they all matter. They all contribute to our opinion and our service to the Court, whether you’re requesting a record for the third time, or sweating it out on the stand in a painful cross examination. Going to Court to defend our opinions is the playing field we signed up for, so charging extra for testimony is hard for me to understand.
Can I charge for my time waiting or travelling, and can I charge a no-show fee?
Generally, I do charge in some form for all of those. The specifics will depend on your retainer agreement so you have to consider how you want to handle these things and make sure it’s all above board. If something comes up that I forgot or didn’t know to have in my agreement, I see it as the honorable thing to do to eat those costs.
I charge my full rate door to door on private rate cases. That includes travel and wait time. I charge in 15 minute increments and round up. For state paid cases, I am authorized for 60% of the state hourly rate for travel, which is usually enough to make it worth a 2-hour roundtrip to the jail. But travel reimbursement is only authorized outside of the metro for some reason I’ll never understand. That means I take fewer and fewer cases in the metro, unless I can ensure a virtual interview, because otherwise I’m eating 2 hours of actual time I took to drive, process in, out, and get home.
No-shows are a little more nuanced, because there are defendant no-shows but then there are also hearings that I hold in my schedule and then they go away. Depending on your jurisdiction they may or may not be respectful of letting you know ahead of time, and sometimes it’s about their own organization. They can’t let you know what they didn’t decide until the day-of (and of course, sometimes this is unavoidable, with last-minute negotiations or legal maneuvering). Some people charge either a half or full day rate and say that charge is assessed if cancellation doesn’t happen within "x" window (maybe 48 hours, but sometimes longer). The problem is that this can depend somewhat on the area of practice. Family Court cases in my area are much less volatile in scheduling because it’s often two busy parents and two private attorneys who have agreed to a Court date months ahead of time. But competency? Good luck! So I try to arrange a policy that is responsive to the various places I practice. For me, that means a flat fee for less than 72 hours notice for private work, but I maintain discretion about whether that fee is appropriate in a given situation. In most cases, I waive it unless I feel like they’ve been blatantly disrespectful of my time. Like if I find out the hearing was rescheduled a week earlier and they let me show up anyway, I'll bill for my time. But if the defendant no showed the hearing and we had to reschedule, no one planned on that. Similarly with interview no-shows, I almost always forgive one and consider it the price of business - I try to be efficient with time while waiting so it isn't lost, like with record review or requests. But after that I am more likely to charge. Overall though, I try to be reasonable and treat people the way I would want to be treated if I got sick or mixed up my schedule or had something unexpected come up. And I try to remember we're working with mentally ill folks who often have chaotic lives and challenging circumstances, financial struggles, and other barriers.
What should I do if I have hang-ups about money?
It’s hard to understand what a service like ours is “worth.” To some extent, you are being paid for the years of hard work to get where you are, for whatever unique skills and practices you bring to the table, and for the scarcity of people willing to put themselves on the line in a very difficult arena with very hard questions and very high stakes.
On top of all that, most of came from clinical training programs that, either explicitly or implicitly, gave messages about altruism and psychology. In my program we rarely talked about money, and when we did it was disparaging of people who wanted to make it. And so it can be hard to be confident about rates and to know what you “deserve,” especially when you look around and you can’t tell what others are doing or if you’re in the ballpark. The vast majority of people I work with and near are excellent clinicians. I think they deserve what they’re getting paid. I hope people would say the same about me.
But the thing about working in a consumer-driven environment is that if people don’t like my work and don’t like my rates, they don’t have to hire me. This is the primary reason that I don’t think rate transparency is relevant to anti-trust rules. Because if it’s easier for a consumer to recognize that I’m charging $100 more per hour than my very excellent counterpart who is also available, then they should absolutely hire that other person instead. If the byproduct of that is that my counterpart seeing my rate is inspired to raise theirs, then that is an unavoidable dynamic of a capitalist market. Rates will fluctuate to the extent the market can bear. Rate stability is also an important aspect of the economic stability goals of antitrust laws, so if we can settle into a rate scale that is fairly consistent across providers then that’s usually good for consumers, too.
This was a lot. Can you summarize for me?
I charge $220/hour here in the Midwest, which as far as I know is in the mid range for forensic work in this area. In other places, ranges might start at higher than the top of our ranges here, like certain places on the coasts, certain areas of practice, and certain specialists who have become popular enough to command higher.
It’s ok to charge more for forensic work than clinical as long as this is in your policies if you do both, but I typically tend not to interpret that at something like 50% higher (unless you can justify it in testimony). I think it’s unethical to set rates defensively, such as in trying to discourage someone from sending you a subpoena.
It’s ok to charge for travel, wait time, and no-shows as long as you’ve been clear upfront (and that whoever is paying you agrees).
I recommend charging one hourly rate for all forensic tasks, versus a flat fee or different rates for appearances versus other tasks.
If you’re just starting out, getting onto your state’s roster can be a great way to get a referral base, but just like the clinical correlate with insurance panels paying lower than market rates, at some point many clinicians get full and start to prioritize work that pays their full fee. Many of us still try and stay connected to some percentage of fixed-fee work because it is important and interesting and a part of giving back, and keeping that balance may prevent you from feeling like a hired gun.
And lastly, it's ok to make money. You got into this work to support yourself, you worked hard (and paid a lot) to get here, and the lawyers hiring you don’t work for free, either.
Here at Streamline, we're committed to using our powers of psychology for good. Starting from the science and empirical literature but arriving at the core of what matters. Focusing on what readers and consumers truly want. Keeping sight of what clinicians need. In our blog, videos, and courses, we’re here to serve clinical and forensic assessment psychologists, especially those early-to-mid-career with an eye toward improvement, innovation, and inspiration.
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